1 Psychosocial Support Programming: Applied Practice in HIV Programs Shannon Senefeld Naomi Van Dinter Daphyne Williams

2 For the purposes of brevity, this presentation will focus specifically on HIV.

3 Group Discussion What is Psychosocial Programming?

4 Activity Break into small groups Case studies Report out Feedback from group

5 Unpacking the Language Psychosocial: –Refers to the dynamic relationship that exists between psychological and social effects –Addresses the ongoing psychological and social problems of HIV infected individuals, their partners, families and caregivers. Psychosocial interventions: –Activities that promote people’s ability to effectively and satisfactorily meet the demands in their lives through healthy and rewarding social relations and interactions, effectively deal with and overcome the adversities which they face in their lives, and continue to develop psychologically and socially throughout life.

6 Why is it important? Cross-cutting Coping Stigma Adherence Prevention

7 Applying PSS to Children PSS for PLHIV is important overall as HIV provides such a unique, long-term chronic stressor. Interventions vary depending on the target group: PLHIV, families affected by HIV, children affected by HIV, etc. For brevity, we’re going to look at children here.

8 Goals of Psychosocial Programming with Children To foster secure attachments with caregivers To create and maintain meaningful peer relationships, friendships, and social ties To instill a sense of belonging To contribute to a sense of self-worth and value, self-esteem and well-being To build, reinforce and maintain a trust in others To increase access to opportunities for cognitive development and functioning To increase spiritual development To support physical and economic security To encourage hope, optimism, and belief in the future

9 Select Principles of PSS with Children Nearly all children and adolescents who have experienced catastrophic situations will initially display symptoms of psychological distress. Most children will regain normal functioning once basic survival needs are met. Some children will require more specialized interventions Counseling should not be the point of departure for psychosocial programming. Counseling should always be carried out by professionals! The psychosocial wellbeing of adults, particularly parents and caregivers has a direct impact on that of children, and should also be addressed. People’s participation in decisions which affect their lives has a positive effect on their mental health, empowers them and helps them to regain control over their own lives. All interventions should be culturally appropriate.

10 Key Areas of PSS for Children

11 Life Skills Camps In a venue away from home, the children participate in activities and team building exercises that help them to develop their: – problem solving and goal setting skills, –teamwork, –confidence, –risk assessment abilities, –trust in others, –conflict resolution, –capacity to face challenges, –as well as other life- affirming skills. Photo: Giacomo Pirozzi

12 Community Camps Offers many of the benefits of the Life Skills Camp without the cost of transportation and accommodation Allows other community members and leaders to become involved Eases transfer of skills acquired into daily life. Photo: Horizons Report, June 2005

13 Kids Clubs Provides a consistent safe environment for children to meet and interact with each other Allows for more flexible structures –Broad focus ( including drama, poetry, life skills training, athletics, debate, study groups, etc) or specific focus, such as agriculture or health –Highly structured or open form –Adult or child-directed Offers a way to stimulate participation by teachers, community leaders, and volunteers

14 Resilience Characteristics Strong attachment to caring adults and/or peer groups Encouraging role models Socially competent at interacting with adults and children Independent and requests help when necessary Curious and explores the environment Plays actively Adapts to change Likely to think before acting Confident he or she can control some parts of his or her life Involved in hobbies, activities, and has multiple talents Has a close, nurturing connection to primary caregiver who provides consistent and competent care Has connections to competent caring members of one’s own cultural group outside of the extended family Participates in familiar cultural practices and routines Has access to community resources, including effective educational and economic opportunities Has connections to faith and religious groups

15 Protective Factors Has a close, nurturing connection to primary caregiver who provides consistent and competent care Has connections to competent caring members of one’s own cultural group outside of the extended family Participates in familiar cultural practices and routines Has access to community resources, including effective educational and economic opportunities Has connections to faith and religious groups

16 Back to the Activity Is there anything in your original group work that you’d like to change?

17 Questions and Discussion Morning exercise at Masiye Camp Photo: Horizons Report, June 2005

18 Thank You! All photos in this presentation are used for illustrative purposes only and do not necessarily represent HIV+ individuals or AIDS Orphans. Photo: Giacomo Pirozzi